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Using WINROP as an adjuvant screening tool for retinopathy of prematurity in southern Taiwan
Chia-Hung Ko1, Hsi-Kung Kuo2, Chih-Cheng Chen1
1Department of Pediatrics Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Insights
The WINROP algorithm shows promise for screening retinopathy of prematurity in preterm infants in Taiwan. However, its overall sensitivity was lower than in developed countries, particularly for infants under 1000g or 28 weeks gestation.
Area of Science:
- Ophthalmology
- Neonatology
- Medical Technology
Background:
- Retinopathy of prematurity (ROP) is a significant cause of visual impairment in preterm infants.
- Early detection and treatment are crucial to prevent severe visual outcomes.
- The Weighing, Interval, Growth, Redesigned, Ophthalmology, and Perinatal (WINROP) algorithm offers a noninvasive approach to ROP screening.
Purpose of the Study:
- To evaluate the efficacy of the WINROP algorithm for ROP screening in Taiwan.
- To assess the sensitivity and specificity of WINROP in a middle-income Asian country.
Main Methods:
- A prospective study included preterm infants born before 32 weeks gestation from 2008-2010.
- Serial ROP examinations and weekly body weight measurements were recorded.
- The WINROP algorithm was applied, and its performance metrics (sensitivity, specificity, PPV, NPV) were calculated.
Main Results:
- 148 infants were analyzed; 11.5% required ROP treatment.
- The overall sensitivity of WINROP was 64.7%, missing 35.3% of severe ROP cases.
- WINROP could predict treatment needs up to 13 weeks in advance for infants <1000g birth weight or <28 weeks gestation.
Conclusions:
- The WINROP algorithm is an effective noninvasive screening tool for ROP in high-risk preterm infants (<1000g or <28 weeks gestation).
- Overall sensitivity in Taiwan was lower compared to findings in highly developed nations.
- Further validation and potential modifications of the WINROP algorithm may be needed for diverse populations.
Objective:
To study the efficacy of the WINROP (https://winrop.com) algorithm in Taiwan, a middle income, moderately developed country in Asia.
Study Design:
We enrolled all preterm infants born with a gestational age less than 32(+0) weeks from September 2008 to August 2010. The results of serial retinopathy of prematurity examinations according to the screening guidelines in our hospital were recorded. Weekly body weight was also recorded for the WINROP algorithm. The sensitivity, specificity, positive predictive value, and negative predictive value were calculated.
Results:
Overall, 148 infants were included. Seventeen infants (11.5%) received treatment for retinopathy of prematurity. But, six infants (35.3%) were missed when severe retinopathy of prematurity was predicted with WINROP algorithm. The sensitivity is only 64.7%. However, when focusing on the preterm infants with a birth weight < 1,000 g or gestational age < 28 weeks, it could predict the need for treatment up to 13 weeks in advance.
Conclusion:
The WINROP algorithm is a very effective noninvasive screening tool for retinopathy of prematurity, especially in preterm infants with a birth weight < 1,000 g or a gestational age < 28 weeks. However, the overall sensitivity in this report from Taiwan was not as high as that reported in highly developed countries.
